Provider Demographics
NPI:1194848242
Name:SEARHC HAINES MEDICAL CLINIC PHARMACY
Entity Type:Organization
Organization Name:SEARHC HAINES MEDICAL CLINIC PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:GOROSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:907-766-6530
Mailing Address - Street 1:131 FIRST AVE SOUTH
Mailing Address - Street 2:
Mailing Address - City:HAINES
Mailing Address - State:AK
Mailing Address - Zip Code:99827-1549
Mailing Address - Country:US
Mailing Address - Phone:907-766-6350
Mailing Address - Fax:907-766-3341
Practice Address - Street 1:131 FIRST AVE SOUTH
Practice Address - Street 2:
Practice Address - City:HAINES
Practice Address - State:AK
Practice Address - Zip Code:99827-1549
Practice Address - Country:US
Practice Address - Phone:907-766-6350
Practice Address - Fax:907-766-3341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK365332800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332800000XSuppliersIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy